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New to CPAP, Events all Over the Place
#1
New to CPAP, Events all Over the Place
Hi Everyone. Hoping somebody can help me out as I'm totally new to all of this. I've only been using my machine for a few weeks and have been struggling to sleep with it for more than 2-3 hours at a time. When I do sleep my AHI is all over the place and very high some nights. Also, events are mostly central, hypopnea, and RERA.  

A little background. I had GI bug and bad flu (I think it was the flu...) back-to-back in February. Soon after I started having this strange sensation when falling asleep that I would "forget to breathe" and it would happen over and over. Then I had an episode of Atrial Fibrillation (have them every few years) in April which sent me to the ER. Finally visited sleep doc and he had me do an at home test, the results of which are below:


The study was performed with a Nox T3 home sleep apnea test device recording nasal air flow, oxygen saturation, heart rate, snoring, thoracic effort, abdominal effort and position. Hypopneas were scored with a 3% oxygen desaturation criterion. The entirety of this study was reviewed by this interpreter including raw data.

Hypopneas were scored with a 4% oxygen desaturation criterion. Following the study the patient reported that he fell asleep in 15 minutes and that he slept6 hours. He reported sleep quality was fair.

DESCRIPTION: Recording start time was 9:55 p.m. and end time 5:47 a.m. Total recording time was 468 minutes. The patient estimated sleep duration of 360 minutes. Average heart rate 58, high was 96 and low was 46. There were 45 apneas of which 37 were central and 22 hypopneas. REI was 11 based on patient estimate of sleep duration and based on device recording of time in bed AHI was 9. Oxygen desaturation index were 8. Minimum oxygen saturation was 90%, baseline was 95% and average was 95%. Audio monitor suggested mild snoring. Supine AHI was 13.8 during 238 minutes in the supine position, 2.1 during 87 minutes on the left and 3.8 during 143 minutes on right side.

INTERPRETATION:

This study shows evidence of mild sleep-disordered breathing.
Central apneas predominated. These may actually be obstructive events appearing central on this device.
Sleep-disordered breathing events were most common in the supine position.


I attached my results from two nights ago because they seemed pretty wild. I fell asleep after 10PM and slept till about 2AM at which point I turned off CPAP. Tried putting it on again around 4am and struggled to fall sleep (not sure if I actually did) until just after 5AM. 

Concerned that my machine is making things worse. Forgetting to breathe as I fall asleep is really messing with me head. I know there is a breaking in period of months, but I wonder if I should keep my current settings: Auto 5 min 20 max, Ramp 5 cmH2O, Ramp Time 20 minutes, Flex set to 2. Or maybe this is the wrong machine for me? 

Thanks

           
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#2
RE: New to CPAP, Events all Over the Place
Your sleep study showed predominantly CA events and not Obstructive but whoever did the interpretation ignored them and decided to provide you with a standard device that will not treat CA’s

This study shows evidence of mild sleep-disordered breathing.
Central apneas predominated. These may actually be obstructive events appearing central on this device.


You are now on a path, when you go back to your Dr point out all of the CA’s recorded on your machine and you don’t feel any better

You will then get prescribed a BiLevel after another sleep study
This will not help in the slightest in fact your AHI will probably go up....

Then you may get prescribed a Bilevel with a backup Rate like an ST device this will still fail


Eventually if you have stayed the course (6months to a year or more) you will get a ASV machine following heart tests and your mild apnoea will be resolved... Great isn’t it
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#3
RE: New to CPAP, Events all Over the Place
Thanks for the reply. That path doesn't sound great but based off my disinterested sleep doc and his lack of follow-through it somehow rings true.

I'm still hoping that a majority of these are false events and that I'm actually awake and throwing the machine off. Last night after 3 hours my AHI was only 4.07 and my Clear Airway and Obstructive were both 0.31
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#4
RE: New to CPAP, Events all Over the Place
Turn off your flex to minimize your Central apnea and because you are on a PR machine without PS or EPR flex doesn't count, increase your min pressure to 8 to manage you flow limits, RERAs, and hypopneas.

Flex = off
Min press = 8
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#5
RE: New to CPAP, Events all Over the Place
Will change those settings for tonight. Thank you!
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